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Are Washington Hospitals Overwhelmed

author
David Lawrence
• Sunday, 17 January, 2021
• 12 min read

The trend is highlighted in new data added to the state’s Risk Assessment dashboard today. The updated hospitalization data show occupancy of ICU beds, where capacity is likely to be exceeded first.

(Source: edtvproductions.com)

Contents

Additionally, the dashboard has been updated to reflect data by region, as opposed to counties. “Accurate and relevant data is critical to allow all of us to work together to ensure no individual hospital or region is overwhelmed with COVID-19 cases” said Darcy Gaffe, senior vice president of safety and quality for the Washington State Hospital Association.

“As cases have risen again in Washington, it is important to use technology and data analytics, so we can have a better understanding of what resources and capacity we have at our hospitals to help those needing care. We are committed and honored to work with local and state officials to understand and stop the spread of COVID-19.” John Khan, VP, Chief Data Analytics Officer, and global lead for the AI for Health program, Microsoft.

Wear a mask around people you don’t live with (even close friends and family). Given current rates, Loft said, disease modelers estimate 150 coronavirus patients will be admitted daily to Washington hospitals.

“If Nov. 16 restrictions that the governor recently announced are successful as they were back in March, we can reverse this trend,” she said. At Swedish First Hill Hospital in Seattle, 10 COVID-19 patients were admitted within five hours Wednesday morning, said Dr. Elizabeth Wake, chief operating officer.

“What we’re hearing from hospitals is that finding the staff who can work in the ICU is one of the limiting factors,” Loft said. However, hospitals and clinics are continuing to see fewer patients seeking care.

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“In oncology, we’ve seen patients presenting with late stage disease,” Wake said. Craig Sailor has worked for The News Tribune since 1998 as a writer, editor and photographer.

The federal government’s projections show that, in a moderate disease outbreak, 200,000 people will need intensive care. If hospitals are inundated with critically ill patients all at once, clinicians will be forced to ration scarce resources such as ventilators and ICU beds.

(Doctors in Italy and China have faced this untenable situation over the past few months, and patients have been denied care and have died as a result.) And even if it doesn’t, spreading out the rate of infection would avoid the worst-case scenario of overwhelming hospitals in a concentrated period of time.

Everyone should minimize social contact, in addition to practicing good hand and face hygiene and taking other preventive measures. Medical staff at Johns Hopkins Hospital are getting ready for an influx of cases of the novel coronavirus.

Depending on the availability of tests in your area, you’ll probably be told to go home, self-isolate and treat your symptoms with fluids, rest and over-the-counter medications. In trying to meet the demands of worried patients and reduce the burden to ER's, many doctors are ramping up telemedicine consultations.

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In the meantime, hospitals are putting into place their pandemic preparedness plans to increase surge capacity. Our individual actions can change the trajectory of this disease, reduce strain on our health-care system and save lives.

And he expects “some very large numbers with the spread from the holiday gatherings combined with the backlog and testing and reporting that may have occurred during the last 10 days.” Andrew Cuomo said Monday there has been a spike following the recent social gatherings that took place.

When asked about the discrepancy between the vaccine doses distributed and those administered, Operation Warp Speed chief scientific adviser Once Status said “nothing has gone wrong,” adding it’s the responsibility of the states to actually administer vaccines. While some states have acknowledged on-the-ground issues that have contributed to delayed vaccinations, many have for months said they needed significantly more federal funding to be able to execute vaccine-rollout plans.

The US government currently withholds about half of the available vaccine supply, distributing it to states and other jurisdictions weeks later to be administered as a second in a two-dose series. The decision, Status said, ultimately rests in the hands of the Food and Drug Administration.

“At this time, suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the available evidence. Parts of the US are beginning to feel the brunt of last month's holiday celebrations -- at a time when hospital systems are already at their breaking point.

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Meanwhile, 750 hospitals have exceeded 90% capacity in their intensive care units, where patients in critical condition are treated. When hospitals are overwhelmed, it becomes challenging for doctors and nurses to provide COVID-19 patients with the attention care they need and can lead to further loss of life.

The new HHS dataset provides a granular picture of these grim national statistics, including counts of patients and hospital beds at the individual hospital level for more than 4,000 facilities across the country. Staffing shortages are highest in Arkansas (33.6% of hospitals in the state), Wisconsin (35.6%), and North Dakota (42.0%).

Barnett works for The Arc Oregon, the agency that was Sweeney's guardian. She had helped Sweeney fill out that document, called a POST form, for a moment just like this.

Sweeney's case offers a rare look at how those decisions are made. Because she couldn't eat solid foods, someone fed her a supplement of nutrients through a tube to her stomach.

She loved country music, especially Kenny Cheney, whose poster she had on the wall of her room. Her dark hair is dyed a bright red, a color that clashed with her neon-pink wheelchair.

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(Source: www.chroniclelive.co.uk)

On April 21, a Tuesday, in the emergency room at Providence Willamette Falls Medical Center, the doctor wrote down his diagnosis: “acute cystitis with hematuria,” a urinary tract infection with the presence of blood in the urine. Those would be signs of pneumonia, a common killer of people with intellectual and developmental disabilities.

It is not unusual for people with swallowing problems to have a chronic build up of saliva in their lungs that they live with every day, sometimes called “silent aspiration.” NPR made multiple requests to speak to doctors, staff, and officials at the Providence Willamette Falls Medical Center.

“We do not pressure or force anyone to sign a DNR order, and we are unaware of any evidence to the contrary. After the first test, Sweeney was moved from the ICU, back to the general floor of the hospital.

Nearly a week later, on Monday, April 27, another doctor who was leading the care team called Barnett, and said it was “urgent” that she come to the hospital. She asked what that meant “in medical terms” and he explained that her lung was filled with fluid and not receiving oxygen.

But then the doctor surprised Conger and Barnett, the women say, when he pushed to rewrite Sweeney's care document. “He said intubating her was a matter of risk versus quality of life,” Conger recalls.

(Source: kutv.com)

The next day, Tuesday, April 28, Conger filed the complaint, in a phone call with a hospital official. Keenan-Mudrick, the executive director of CAS, would later testify, in the state Legislature, about this incident and the doctor’s “pressure” to change Sweeney’s orders to a DNR.

Anna Keenan-Mudrick, executive director of Community Access Services, told state lawmakers how her staff pushed back when doctors and social workers wanted to override Sweeney's legal document asking for full medical care. Conger, in her complained with the hospital, too, protested the pressure to change Sweeney's stated wishes for health care.

At The Arc Oregon, Barnett spoke with her bosses and decided they should try to find another hospital for Sweeney. She got a call back from another doctor who told her that insurance would not pay to transfer Sweeney, according to Barnett's notes.

It's common that doctors often see someone with multiple disabilities, like Sweeney, one way and the person's friends, family and caregivers see her another. A “vast majority” of doctors say people with a significant disability have a worse quality of life, according to a recent poll by Dr. Lisa Cuzzoni, a Harvard Medical School professor and physician who studies health care disparities for people with disabilities.

There are, for sure, doctors who take extra steps to understand the lives of their patients with disabilities and who work to help them achieve health and independence. It was to help the disabled woman live as full a life as possible, according to her wishes.

(Source: www.sfgate.com)

Because Sweeney couldn't move her fingers to type on a keyboard, the Dynamo was set up to track where her eyes gazed. She could look at a letter or a symbol on a computer screen and the device would read and then speak it for her.

Hospital records say the medical team was debating the best course for Sweeney, who was now dealing with aspiration pneumonia. The palliative care nurse argued in favor of keeping Sweeney at full code, to honor her goal to try to get better and go home.

“We typically do not have this issue of the hospital not directly returning calls to our RN's,” she said. The pulmonologist called Barnett twice, according to her notes, to say Sweeney's lungs were improving and that she was breathing more easily.

On Thursday, May 7, Barnett looked into possibilities to move her out of the hospital to a group home with nurses who would suction her lungs and provide medical care while she recovered. It would be a temporary stop before she moved back to her group house in Oregon City.

On Friday, May 8, a caseworker called to say Sweeney's lungs were failing. There had been added episodes of aspiration pneumonia, on April 29 and May 7 and a clogged feeding tube on May 2 that, according to Brahman, Barnett and Conger, had not been disclosed to them.

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(Source: www.southeastiowaunion.com)

The next day, on Saturday, Conger and Barnett were summoned to the hospital to talk about Sweeney's worsening condition. Discovery was the program that was helping Sweeney figure out a way to use that voice computer and find a job.

“She was struggling to get air,” Conger remembers, “and you could just see the panic and the fear in her eyes. Now, Conger and Barnett agreed with the medical staff that it was time to begin palliative, or comfort, care for Sweeney.

Just hours later, at 3:30 Sunday morning, a phone call woke up Barnett at her home. Painted rocks sit outside Sarah Sweeney's group home in Oregon City, Ore., on Nov. 24, 2020.

Conger says doctors could have stopped the feeding tube and instead fed Sweeney through an IV line. Conger and Barnett said they made repeated suggestions for the IV feedings.

Hospital records say a doctor considered it and concluded there was “no evidence” that it would make a difference. Over more than two and a half weeks, doctors and social workers had questioned why this disabled woman had medical instructions for full care, instead of a do-not-resuscitate order.

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(Source: www.seattletimes.com)

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